Abstract
Mr. M is a 64 y/o man with a prior hiatal hernia repair, who presented with abdominal pain, nausea, and emesis. CT demonstrated a recurrent paraesophageal hernia containing small bowel and colon, with evidence of large bowel obstruction within the hernia sac. He was taken to the OR and underwent open reduction of the hernia and primary repair of the diaphragmatic defect with absorbable mesh reinforcement. Post-operatively, he initially did well and had his nasogastric (NG) tube removed on post-op day 1. After 4 days of poor oral intake, however, he developed bilious emesis and the NG was replaced. CT with enteral contrast demonstrated early post-op small bowel obstruction with a transition point in the mid-abdomen. This was managed non-operatively, and by post-op day 9 he was able to resume oral intake. However, in the meantime, he developed a partial midline fascial dehiscence and a stage II sacral decubitus ulcer.
Original language | English (US) |
---|---|
Title of host publication | The Acute Management of Surgical Disease |
Publisher | Springer International Publishing |
Pages | 505-530 |
Number of pages | 26 |
ISBN (Electronic) | 9783031078811 |
ISBN (Print) | 9783031078804 |
DOIs | |
State | Published - Jan 1 2022 |
Keywords
- Enteral
- Nutrition
- Parentral
- Protein
- Surgery
ASJC Scopus subject areas
- General Medicine